172 



CHARLES C. GROVE 



WHY.INYOUR OPINION ARE THERE FEWER BIRTHS NOW ? 



USE NUMERAL INOROER OF IMPORTANCE. AS1.2.3.ETC. 

 ECONOMIC CONDIWNsl ) hEALTh { \ fFAR OF CHILD BIRTh { ) PHYSICAL INABILITY.( ) MARRIAGE LATER IN L/FE\ ) 



interference with PERSONAL aspirations{ ) FEAR QEMEREMASL P/SEASEJ ) IMEBEH IDEA L S QN sex 8£L£m. ( ) 



FURTHER REASONS AND REMARKS: — 



NOTE:- STATE NUMERICAL GRADE OR YEAR IN COLUMN ON EDUCATION. 



DATES OF BIRTHS IN ORDER OF ALL CHILDREN LIVING AND DEAD IN THE SEVERAL 



GENERATIONS 



FOR LIVING G/VE:-sex(s-d),birth date, extent of education (date\single or married (date)occupation,num- 



BER OF CHILDREN. 



FOR DEAD GIVE:— SEX(S-D),BIRTH DATE, DIEDlfiATtiCAUSE OF DEATH. EXTENT OF EDUCATION. OCCUPATION AT DEATH. 

 run Ut-HU 17/ rt. \ I v I- NUMBER OF CHILDREN. 



PRESENT 

 FAMILY 



HUSBAND'S 

 FAMILY 



WIFE'S 

 FAMILY 



S FEBS 1885 LIVING COLL EGE AB 1905 MA RRIED 190 6 SUPT OF SCHOOLS 



D JUNE 15.1887 DIED O CT 18 1819 I1FLUENM IN Sth CRADEATSCHQOL^ 



S.DEC 14 1880 LIVING COLLEGE B 5 1909 PH O.I9I3 MARRIED 1914 CHEMIST 



PREVIOUS 

 GENERATIONS 



IF SPACE IS NOT SUFFICIENT. PLEASE USE 8%'xiEPAPER AND ENCLOSE WITH CARP 



